Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
Waldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case o...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/4/1007 |
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| author | Juan Carlos Caballero Elham Askari Nerea Carrasco Miguel Angel Piris Begoña Perez de Camino Laura Pardo Javier Cornago Jose Luis Lopez-Lorenzo Pilar Llamas Laura Solan |
| author_facet | Juan Carlos Caballero Elham Askari Nerea Carrasco Miguel Angel Piris Begoña Perez de Camino Laura Pardo Javier Cornago Jose Luis Lopez-Lorenzo Pilar Llamas Laura Solan |
| author_sort | Juan Carlos Caballero |
| collection | DOAJ |
| description | Waldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case of a 77-year-old woman diagnosed with WM following the development of severe and sudden pancytopenia associated with a cold agglutinin syndrome. In order to treat the WM and the underlying hemolysis, treatment with rituximab, corticosteroids and cyclophosphamide was started. Despite the improvement in hemolysis parameters, pancytopenia persisted, and we started a second line with ibrutinib. During treatment the patient developed an uncommon invasive fungal infection (IFI) with bone marrow granulomatosis and myelofibrosis. This case shows an unusual clinical course with a poor hematopoietic response to treatment and a large number of intercurrent complications. |
| first_indexed | 2024-03-11T05:13:19Z |
| format | Article |
| id | doaj.art-aec131afc4a648ae875eb6a9c1fe91b6 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T05:13:19Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-aec131afc4a648ae875eb6a9c1fe91b62023-11-17T18:25:13ZengMDPI AGBiomedicines2227-90592023-03-01114100710.3390/biomedicines11041007Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly PatientJuan Carlos Caballero0Elham Askari1Nerea Carrasco2Miguel Angel Piris3Begoña Perez de Camino4Laura Pardo5Javier Cornago6Jose Luis Lopez-Lorenzo7Pilar Llamas8Laura Solan9Hematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainInfectious Diseases Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainPathology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainHematology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, SpainWaldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case of a 77-year-old woman diagnosed with WM following the development of severe and sudden pancytopenia associated with a cold agglutinin syndrome. In order to treat the WM and the underlying hemolysis, treatment with rituximab, corticosteroids and cyclophosphamide was started. Despite the improvement in hemolysis parameters, pancytopenia persisted, and we started a second line with ibrutinib. During treatment the patient developed an uncommon invasive fungal infection (IFI) with bone marrow granulomatosis and myelofibrosis. This case shows an unusual clinical course with a poor hematopoietic response to treatment and a large number of intercurrent complications.https://www.mdpi.com/2227-9059/11/4/1007Waldenström macroglobulinemiainvasive candidiasisgranulomatosiscase report |
| spellingShingle | Juan Carlos Caballero Elham Askari Nerea Carrasco Miguel Angel Piris Begoña Perez de Camino Laura Pardo Javier Cornago Jose Luis Lopez-Lorenzo Pilar Llamas Laura Solan Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient Biomedicines Waldenström macroglobulinemia invasive candidiasis granulomatosis case report |
| title | Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient |
| title_full | Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient |
| title_fullStr | Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient |
| title_full_unstemmed | Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient |
| title_short | Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient |
| title_sort | invasive cutaneous candidiasis autoimmune hemolytic anemia and pancytopenia a challenging scenario for waldenstrom macroglobulinemia in an elderly patient |
| topic | Waldenström macroglobulinemia invasive candidiasis granulomatosis case report |
| url | https://www.mdpi.com/2227-9059/11/4/1007 |
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